Wake Melissa, Gerner Bibi, Gallagher Susan
Centre for Community Child Health, Royal Children's Hospital, University of Melbourne, Department of Paediatrics and Murdoch Childrens Research Institute, Melbourne, Australia.
Ambul Pediatr. 2005 May-Jun;5(3):143-9. doi: 10.1367/A04-162R.1.
We studied the accuracy of the Parents' Evaluation of Developmental Status (PEDS) at school entry in predicting academic, language, and health-related quality of life (HRQoL) outcomes 2 years later.
DESIGN/METHOD: Prospective population study in elementary schools in Melbourne, Australia. Base Population. A total of 1591 school entry children who participated in a separate cross-sectional study. Cases. One hundred seventy-three children randomly selected from those with significant parental developmental concerns. Controls. One hundred twenty-nine children without significant parental development concerns. Predictors (1997). Parents completed all 10 PEDS items; teachers completed 5 PEDS items. Outcomes (1999). The PEDS and the Child Health Questionnaire (parents) and the Comprehensive Inventory of Basic Skills-Revised and the Renfrew Action Picture Test of language (children). Odds ratios (ORs) were calculated for low outcome scores, defined as >1.0 standard deviation below the mean or <16th centile.
At outcome, case parents reported more "significant" concerns on the PEDS than did control parents (65% vs 26%, OR 5.3), but mean language and academic scores were only slightly lower for case children. Parent-reported self-help and school skills concerns predicted low language (ORs 2.1-2.8) and academic (ORs 1.3-6.6) scores. Teacher concerns about early school skills predicted low academic scores (ORs 3.7-4.7). However, sensitivity and specificity values were modest. Baseline developmental concerns predicted poor scores on a number of domains of HRQoL 2 years later.
Although individual developmental concerns at school entry variably predict later academic and language scores, sensitivity and specificity values would not support use of the PEDS as a stand-alone screen to detect later problems.
我们研究了入学时家长发育状况评估量表(PEDS)在预测两年后学业、语言及健康相关生活质量(HRQoL)结果方面的准确性。
设计/方法:在澳大利亚墨尔本的小学进行的前瞻性人群研究。基础人群。共有1591名入学儿童参与了一项单独的横断面研究。病例。从家长对发育状况有显著担忧的儿童中随机选取173名。对照。129名家长对发育状况无显著担忧的儿童。预测因素(1997年)。家长完成所有10项PEDS条目;教师完成5项PEDS条目。结果(1999年)。PEDS以及儿童健康问卷(家长填写)和基本技能综合量表修订版以及语言方面的伦弗鲁动作图片测试(儿童完成)。计算低结果分数的比值比(OR),低结果分数定义为低于均值1.0个标准差以上或低于第16百分位数。
在结果方面,病例组家长在PEDS上报告的“显著”担忧比对照组家长更多(65%对26%,OR为5.3),但病例组儿童的平均语言和学业分数仅略低。家长报告的自理和学校技能担忧可预测低语言分数(OR为2.1 - 2.8)和学业分数(OR为1.3 - 6.6)。教师对早期学校技能的担忧可预测低学业分数(OR为3.7 - 4.7)。然而,敏感性和特异性值一般。基线发育担忧可预测两年后HRQoL多个领域的低分。
尽管入学时个体发育担忧能不同程度地预测后期学业和语言分数,但敏感性和特异性值不支持将PEDS作为检测后期问题的独立筛查工具。